People with
social anxiety disorder worry about embarrassing themselves in front of other people. Fears may be so serious that they can interfere with everyday activities. It may be very difficult for people with this disorder to interact with others. In some people, fear of social interaction may cause absences from school or work.

Common fears may include:

Blushing or shaking in front of others

Anxiety about meeting new people or giving a speech

This may accompany a belief that people are watching you and waiting for you to make a mistake. Anxiety can occur when on the phone, signing a check at the store, or using a public restroom. If you have social anxiety disorder, you worry about some events for weeks in advance. You may do anything to stay away from the situation.

Social anxiety disorder can be limited to only one type of situation, such as a fear of speaking in formal or informal situations, or eating or drinking in front of others. In its most severe form, you may experience symptoms almost anytime you are around other people.

Social anxiety disorder is common, affecting about 15 million Americans. It is equally common in men and women. The disorder typically begins in childhood or early adolescence and rarely develops after age 25.

The exact cause of social anxiety disorder is unknown. Possible causes include genetic factors, problems with regulation of chemicals in the brain, an imbalance of neurotransmitters or brain hormones, and past emotional trauma in social situations.

Revision Information

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.

Social phobia. Merck Manual Professional Version website. Available at: http://www.merckmanuals.com/professional/psychiatric-disorders/anxiety-and-stressor-related-disorders/social-phobia. Updated May 2014. Accessed June 27, 2017.